Monitoring and evaluation (M and E) are indispensable components of effective program management. M and E are used for decision-making, to assess and improve the care that patients receive, to share effective practices, and to advocate for unmet needs in the target population. Program managers often face difficult choices with regard to where they should focus their M and E efforts. The unit discusses ways to equip program staff with the knowledge, skills, and confidence to develop an M and E system that addresses organizational needs, while taking limited local capacity and resources into consideration.